Tests and diagnosis

Heart murmurs are usually detected when your doctor listens to your heart using a stethoscope during a physical exam.

To check whether the murmur is innocent or abnormal, your doctor will consider:

How loud is it? This is rated on a scale from 1 to 6, with 6 being the loudest.

Where in your heart is it? And can it be heard in your neck or back?

What pitch is it? Is it high-, medium- or low-pitched?

What affects the sound? If you change your body position or exercise, does it affect the sound?

When does it occur, and for how long? If your murmur happens when your heart is filling with blood (diastolic murmur) or throughout the heartbeat (continuous murmur), that may mean you have a heart problem. You or your child will need more tests to find out what the problem is.

Your doctor will also look for other signs and symptoms of heart problems and ask about your medical history and whether other family members have had heart murmurs or other heart conditions.

Additional tests

If the doctor thinks the heart murmur is abnormal, you or your child may need additional tests, including:

Chest X-ray. A chest X-ray shows an image of your heart, lungs and blood vessels. It can reveal if your heart is enlarged, which may mean an underlying condition is causing your heart murmur.

Electrocardiogram (ECG). In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor look for heart rhythm and structure problems.

Echocardiogram. This type of testing uses ultrasound waves to show detailed images of your heart's structure and function. Echocardiography can help identify abnormal heart valves, such as those that are hardened (calcified) or leaking, and can also detect most heart defects.

Cardiac catheterization. In this test, a catheter is inserted into a vein or artery in your leg or arm until it reaches your heart. The pressures in your heart chambers can be measured, and dye can be injected.

The dye can be seen on an X-ray, which helps your doctor see the blood flow through your heart, blood vessels and valves to check for problems. This test is generally used when other tests have been inconclusive.

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